<div class="modal-header">
	<button type="button" class="close" data-dismiss="modal"><span aria-hidden="true">&times;</span><span class="sr-only">关闭</span>
    </button>
	<h4 class="modal-title">添加/编辑地址</h4>
</div>
<div class="modal-body">
	<form action="" class="form-horizontal">
		<div class="form-group">
			<label>收货人:</label>
			<input type="text" name="" value="唐老板" class="form-control" />
		</div>
		<div class="form-group">
			<label>联系电话</label>
			<input type="text" name="" value="13699772411" class="form-control" />
		</div>
		<div class="form-group add-ads">
			<label>收货区域:</label>
			<div class="clearfix">
				<select name="" id="" class="form-control">
					<option value="0">请选择</option>
				</select>
				<select name="" id="" class="form-control"><option value="0">请选择</option></select>
				<select name="" id="" class="form-control"><option value="0">请选择</option></select>
			</div>
		</div>
		<div class="form-group">
			<label>详细地址:</label>
			<input type="text" name="" placeholder="街道,社区,号牌,名称" class="form-control" />
		</div>
	</form>
</div>
<div class="modal-footer">
    <button type="button" class="btn btn-white" data-dismiss="modal">关闭</button>
    <button type="button" class="btn btn-primary saveaddress" data-id="213" >确定</button>
</div>
</div>